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VAPORIZERS
Dr. deepak kumar
Resident in Anaesthesia deptt
S.P.Medical College &
A.G.Hospitals, Bikaner
What is a Vaporizer?
A VAPORIZER IS AN INSTRUMENT DESIGNED TO
FACILITATE THE CHANGE OF A LIQUID ANAESTHETIC
AGENT INTO A VAPOR
AND
ADD A CONTROLLED AMOUNT OF THIS VAPOR TO THE
FGF.
Function of Vaporizers
• Produce vaporisation of volatile agent
• Mix vapour with fresh gas flow
• Control the mixture despite variables
►To deliver safe and accurate concentration of
inhalational agents to the patient.
Applied Physics
• Factors affecting vaporization of a liquid
1.Temperature
2.Volatility
3.Surface area
4.Removal of vapor from the vicinity
of the liquid.
Applied Physics
• Vapor
• Gas
• Critical temperature
• Vapor pressure
• Boiling point
• Partial pressure
• Heat of vaporization
• Specific heat
• Thermal conductivity
• Thermal capacity
Vapor
• Vapor is the gaseous phase of a substance which is
normally a liquid at room temp. and atm. pressure
Gas
• Gas is a substance which exists only in the gaseous
state at room temp. and atm.
Critical temperature
• It is the temperature, above which no amount
of pressure will convert a gas to a liquid.
02=-118.4°C; N2O= 36.5°C; CO2= 31°C.
• The pressure required to liquefy a gas at its
critical temp. is the CRITICAL PRESSURE .
Vapor pressure
• When enclosed in a container molecules of a
volatile liquid break away to form vapor.
• Vapor pressure is the pressure with which they
bombard the walls of the container.
• Vapor pressure depends only on temp and nature
of liquid.
• Vapor pressure of an agent determines how
much of vapour will be formed from 1 ml of the
liquid.
• Since diff anaesthetic agents have diff vapour
pressure so need separate vaporizers.
Boiling point
• Boiling point of a liquid is that temp at
which the vapor pressure is equal to the
atmospheric pressure.
• Lower the atmospheric pressure, lower
the boiling point.
Partial pressure
• The part of total pressure due to any one gas
in the mixture
• Depends on – Nature of liquid and Temp.
• Clinical significance-
Patient uptake and anaesthetic depth are
directly related to partial pressure.
• HEAT OF VAPORIZATION-
It is the number of calories needed to
convert 1gm or 1ml of liquid to vapor.
• SPECIFIC HEAT-
Quantity of heat required to raise the
temp of 1gm or 1ml of substance by 1*c .
• THERMAL CONDUCTIVITY-
A measure of speed with which heat
flow through a substance .
• THERMAL CAPACITY-
Amount of heat stored in vaporizer body
= specific heat x Mass
CLINICAL SIGNIFICANCE-
• liquid with low specific heat vaporize easier.
• Higher the thermal conductivity, better a
substance conduct heat
• Vaporizers construct of material with high
thermal conductivity and specific heat e.g.-
copper, bronze to minimise temp changes
when in use.
Related physics
THERMOSTABILISATION Methods :-
 Vaporizer constructed of metal with high thermal
conductivity.
 Heavy metal parts act as heat reservoir.
 Wicks to be in contact with the metal part so that
heat loss due to vaporization is quickly replaced.
 Immerse vaporizer chamber in a large mass of water.
Related physics
THERMOCOMPENSATION-
• Some means to maintain the vaporizer
output constant despite any temp changes
Methods -
1.Alteration in splitting ratio(automatic
compensation) e.g.- bimetallic strip in Tec
vaporizers, ether filled bellows in penlon
vaporizers, EMO(Epstein Macintosh Oxford)
Related physics
2.Computer control-electronic vaporizers.
3.Manually adjust flow- measured flow ,
drager vapor.
4.Supplied heat- Tec 6(electrically heated).
Properties Of Common Anaesthetic
Agents
Agent Boiling Point at
100 kPa
(degree Celsius)
Vapor Pressure
(at 20 deg C)
MAC value
(vol% ) in 100% O2
1) Ether 34.5 440 19
2) Halothane 50.2 243 0.75
3) Enflurane 56.5 175 1.68
4) Isoflurane 48.5 238 1.15
5) Desflurane 22.8 669 6.4
6) Sevoflurane 58.6 157 2.0
7) Trilene 87.5 57 0.17
Terminology for vaporizers
PLENUM- FGF is pushed in to the vaporizer(high
resistance).
DRAWOVER- Gas is pulled in to the vaporizer by
the patients own inspiratory effort(low
resistance) e.g.- Goldman,EMO,OMV
INHALER- A drawover vaporizer in which the
carrier is air.
SPLITTING RATIO
• The ratio of the bypass gas to the gas going to
the vaporizing chamber is called the splitting
ratio
• It depends on-
1.The resistance of the two pathways, which
inturn depends on the variable orifice of the
inlet/outlet.
2.Temp of the liquid/carrier gas
3. Flow rate of gases.
CLASSIFICATION
• Dorsch & Dorsch classification (1979)
1) Regulation of output concentration
2) Method of vaporization
3) Location of the vaporizer
4) Temperature compensation
5) Specific anaesthetic agent
CLASSIFICATION
• Dorsch & Dorsch classification
1) Regulation of output concentration
a) Variable Bypass type
b) Measured flow type
2) Method of vaporization
3) Location of the vaporizer
4) Temperature compensation
5) Specific anaesthetic agent
Flowmeter
Patient
VARIABLE BYPASS
Flowmeter
Patient
Flowmeter
Patient
MEASURED FLOW VAPORIZER
• Uses a measured flow of carrier gas to
pick up agent
• Consist of-
1.Vaporizer
2.flowmeter assembly
3.Vaporizer circuit control valve
Cont...
• Operator has to set the flow to the vaporizer
and bypass with separate flowmeters
• This means that respective flows have to be
calculated for a given temp and vapour
output.
Measured Flow Vaporizer
V V
C
L
CLASSIFICATION
• Dorsch & Dorsch classification
1) Regulation of output concentration
2) Method of vaporization
a) Flow over
b) Bubble through
3) Location of the vaporizer
4) Temperature compensation
5) Specific anaesthetic agent
Flow over
• A stream of gas passes over liquid surface
• Efficiency depend on-
1. Gas-liquid interface e.g.- baffles, spiral
tracks, wicks.
2. Velocity of carrier gas flow
3. Height of gas
Bubble through
• Bubble the gas through the liquid
• efficiency depends on-
1. size of bubbles
2. depth of the liquid
3. velocity of carrier gas
E.g.- sintered diffuser
-cowl in Boyle’s bottle
BUBBLE THROUGH VAPORIZER
CLASSIFICATION
• Dorsch & Dorsch classification
1) Regulation of output concentration
2) Method of vaporization
3) Location of the vaporizer
a) VOC(Vaporizer outside the circuit)
b) VIC (vaporizer inside the circuit)
4) Temperature compensation
5) Specific anaesthetic agent
In system vaporizer(VIC)
• Should have standard male and female 22 mm
fittings or standard screw threaded
fittings,inlet and outlet ports should have
arrows.
• Should have low resistence.
• Vaporiser concentration and output vary
• Easy to wash and clean
• Drawover vaporizers eg- goldman,EMO,OMV
OUT OF SYSTEM VAPORIZERS(VOC)
• Usually on back bar – b/w flowmeter and FGF
outlet
• Most variable bypass vaporizers and all
measured flow vaporizers are VOC type.
CLASSIFICATION
• Dorsch & Dorsch classification
1) Regulation of output concentration
2) Method of vaporization
3) Location of the vaporizer
4) Temperature compensation
a) Non compensated
b) Compensated
5) Specific anaesthetic agent
EFFECTS OF TEMPERATURE
GIVING HEAT
TEMP COMPENSATION
• To maintain a constant output from the
vaporizer,mechanisms to compensate for the
fluctuations in temp are to be employed.
• Method –
1. automatic- alteration in the splitting
ratio(bimetallic strip in tec vaporizer,ether
filled bellows in penlon vaporizers,EMO
2.Supplied heat- tec 6(electrically heated)
3.Computer control- electronic vaporizers
TEMPERATURE COMPENSATED
TEMPERATURE COMPENSATED
BIMETALLIC STRIP
BIMETALLIC STRIP
TEMPERATURE COMPENSATED
CLASSIFICATION
• Dorsch & Dorsch classification
1) Regulation of output concentration
2) Method of vaporization
3) Location of the vaporizer
4) Temperature compensation
5) Specific anaesthetic agent
a) Agent specific
b) Multiple agent
CLASSIFICATION
• Gray & Nunn Classification (1971)
1) Plenum vaporizers
2) Draw over vaporizers
3) Vaporizers for use inside a circle anaesthetic
system
CLASSIFICATION
• Gray & Nunn Classification
1) Plenum vaporizers
Fresh gas flow is forced into a chamber
Unidirectional gas flow
Relatively high resistance to gas flow
e.g. Boyle vaporizer, copper kettle,
Tec series vaporizers
CLASSIFICATION
• Gray & Nunn Classification
2) Draw over vaporizers/ Inhalers: Air or
anaesthetic gases drawn over or through the
vaporizer either by pt’s own respiratory efforts
or by a self inflating bag or manual bellows.
Very low resistance to gas flow
e.g. EMO vaporizer, Oxford
miniature inhaler, emotril, tecota
vaporizers.
CLASSIFICATION
• Gray & Nunn Classification
3) Vaporizers for use inside a circle anaesthetic system
e.g.- Goldman vaporizer
Rawbotham vaporizer
NEWER CLASSIFICATION.
METHOD OF REGULATING OUTPUT CONCENTRATION
(1) Conc. Calibrated
(2) Measured flow
METHOD OF VAPORISATION
(1) Flow over
(2) Bubble through
(3) Injection
TEMP. COMPENSATION
(1)Thermocompensation
(2) Supplied heat
Factors affecting vaporizer
performance
• Flow rate
• Temperature
• Barometric pressure
• Intermittent back pressure
• Gas direction
• Liquid levels
• Anaesthetic agents
• Carrier gas composition (N2O causes transient drop)
Factors affecting vaporizer
performance
• Flow rate
At high flows,the vaporizer delivers less
anaesthetic concentration than is set on
the dial
problem is solved by increase the surface
area of contact b/w the fresh gas and
anesthetic agent
Eg- WICKS
TEMPRATURE
• As anaesthetic molecule escape temp
decreases more difficult for the
remaining molecules to escape less
vaporisation.
• Thus at lower temp there is less
vaporization.
• Problem solving-
 Giving heat
 Giving flow
Giving heat
1.Vaporizer material
good conductor(high thermal conductivity)
act as a heat reservoir(high specific heat)
2.Supplied heat (tec-6 electrically heated)
Giving flow
• Giving flow (thermocompensation) by
alteration in splitting ratio
1. Mechanically
2. Compuer controlled
Factors affecting vaporizer
performance
• Intermittent back pressure
Pumping effect(hill and lowe effect)
Pressurizing effect(cole effect)
Pumping effect(Hill and lowe effect)
• The effect of changing pressure during IPPV
increasing the output of the vaporizer is called
the “pumping effect”
• During positive pressure ventilation, pressure
transmitted back results in compression of
gas.
• Since the vaporizing chamber volume is much
larger than the ‘by pass’ channel volume,
more fresh gas gets compressed in to it.
Cont…
• This extra fresh gas that enters the vaporizing
chamber collects anesthetic vapour
• Some of the rapidly expanding gas (containing
vapour) enter the inlet of the vaporizer and
cross over into the ‘bypass’ channel.
• The addition of the ‘bypass’ vapour to the
vaporising chamber raises the final
concentration of anesthetic delivered.
Pumping Effect
Pumping Effect
Pumping Effect
Pumping Effect
Pumping Effect
Pumping Effect
Modifications to reduce the
‘pumping effect’
• By pass channel made larger
• Inlet tube made longer
• Exclude wicks from inlet
• Increased resistance – a high internal
resistance to “resist” changes to flow.
• Check valve at outlet of the vaporizer -Fluotec
2
• Check valve upstream to junction with the
oxygen flush.
• Pressure relief valve.
Large bypass channel
Long inlet tube
Increased resistance
One way valve (open)
One way valve (closed)
Pressurising effect
• k/a ‘cole effect’ – decreased output of
anesthetic agent.
• An inreased in pressure causes an increased
pressure inside the vaporizer.The carrier gas is
compressed but the vapour pressure of the
volatile anesthetic is unaffected.Net result
decreased conentration of anesthetic
delivered.
Pressurizing Effect
Carrier gas composition
• Most vaporisers are calibrated using 100% o2
• Composition of carrier gas affects output in
many(vaporiser aberrance)
• If add N2O- decreased output(25% less with
100% N2O)due to solubility of N2O in agent
.As N2O dissolves in liquid anaesthetic.Flow of
gases exiting vaporiser decreases.
• Once saturated with N2O output gradually
increases but is less than before(10% less with
100% N2O.
EFFECT OF BAROMETRIC PRESSURE
• Vaporizers are calibrated at std. atmospheric
pressure(at sea level)
• Low boiling point,high SVP anaesthetic volatile
agents- more susceptible to influence by
barometric pressure.
• Vapour pressure of agent is independent of
barometric pressure.
• Effect of low atm. Pressure- deliver HIGHER
concentration if measured in volume% but
deliver same partial pressure
Cont….
• Clinically effect unchanged
• Effect of high atm.pressure-
increased density of gas increased
resistance through vapourising chamber
decreased vapour output both in partial
pressure and volume%
SPECIFIC VAPORIZERS
Early methods
• OPEN DROP METHOD:-
Inhalational anaesthesia by
vaporization of a liquid anaesthetic placed
drop by drop on a gauze/ mask covering the
mouth and nose.
Devices- Schimmelbusch mask
other modification- Yankauers, Bellamy
gardner
CONT..
• SEMI OPEN-
a frame added to “keep the ether in” in
an enclosed area- permitted some degree of
rebreathing.
e.g.- Ogston’s inhaler
Flagg’s can
Early devices- open drop
method(schimmelbusch mask,
yankaeur mask and bellamy
gardner wire mask)
Semi open drop method
Ogston mask with schimmelbusch
frame
MORTONS ETHER INHALER
OPEN ETHER ADMINISTRATION
• TECHNIQUE-
Volatile anaesthetic dripped on to a gauze:
1. ETHER- 16 layers gauze over mask
2. CHLOROFORM/ETHYL CHLORIDE- 12 layers of gauze/1
layer lint(chloroform dropped over half the area)
- gradually increased no. Of drops/min
- During inspiration air passed through the gauze and
vaporizes the liquid anaesthetic into high
concentration.
Open drop ether
• Bellamy gardner dropper
- amber coloured
- control on pouring
- capacity – 90 ml ether
INDUCTION
• WITH ETHER
• RATE OF DROPS
1ST
min = 12 drops = 1 %
2nd
min = 25 drops = 3 %
3rd
min = 50 drops = 6 %
4th
min = 100 drops = 10-12 %
• ETHYL CHLORIDE - 3 to 5 ml - 3 to 5 %
• Rate of drops
1st
min = 30 drops
2nd
min = 60 drops
3rd
min = 90 drops
MAINTENANCE
• Conc.for maint. with ether is 6 -8 %
• Heat loss = 200-300 cal/min
• Temp. above and below mask = 2-3 degrees <
room temp.
• Temp. at mask = 0 – 1 degrees C
• Gas comp.under mask
0% ether = 80% N2 + 20% O2
5% ether = 76% N2 + 18% O2
10% ether = 72% N2 + 16% O2
Advantage of open drop
• Easy to administer
• Low dead space 40-60 ml
• Low resistence
• Wide margin of safety
• Relatively cheap
Disadvantage of open drop
• Significant rebreathing
• Hypoxic mixtures may occur
• Poor control of inspired gas concentration
• Inability to assist or control ventilation
• No conservation of heat or humidity
• Difficult airway management especially during
head and neck procedure
• Pollution of the operating room
• Hazardous especially with flammable agents.
• Skin burn.
• Eye injury
In system vaporizers(VIC)
• There are two ways that gas flows through a
vaporizer
- push through
-Drawover
Drawover anaesthesia
• Drawover system :
- provide anaesthesia without a supply of
compressed gases.
-Atmospheric air – main carrier gas
-drawn by the patient’s inspiratory efforts
- volatile agent (ether or halothane) added
to vaporizer
- Inhaled by the patient via a non-rebreathing
valve.
Drawover anaesthesia
• The component of a drawover circuit
EMO Vaporizer
Epstein, Macintosh, Oxford (EMO) introduced
in 1952
Classification-
• Variable bypass/conc. calibrated
• Flow over with wicks
• Temperature compensated by supplied heat and
altered flow.
• Agent specific-used for ether, halothane, chloroform
and trilene.
• Can be a part of a drawover system or used as a
plenum vaporizer
• Low resistance(<1.25cm water at 40 Lpm flow)
EMO VAPORIZER
• Wt- 6.5 kg ; ht 24cm ;dia
23cm
• TRANSIT position- seals
ether chamber
• CONTROL lever-upto 20%
• INLET/OUTLET – R to L
• TAP for filling /draining
water chamber at bottom
• Outlet(male)
inlet(female)
• 1250ml water filled in
water chamber
A- Inlet
B- Outlet
C- Water compartment
D- Ether
E- Vaporizing chamber
F- Thermo compensating
valve
G- Off/on valve
H- Mixing chamber
I- Water drain
Ctd
• FILLER-depress to fill (control lever at 0-not
transit- for air to escape) springs back
automatically.
• LEVEL INDICATOR- moves only after 150 ml ; add
300ml for full (fill with control at 0 –not at ‘in
transit’.
• TEMP.INDICATOR-rod with black & red bands
and metal top
20-25 degrees-black line with metal top
>32 degrees – red band- temp above
working range
EMO(ctd)
• Thermocompensation mechanism at outlet of
v.c.
– metal bellows with liquid Ether[ether capsule] &
connected to plunger
– temp. range; 15-29 degree Celsius
• Water jacket serves as heat reservoir
Checks
(1) check level indicator-> put “in transit”-> invert –
indicator should fall to full.
(2) close outlet- connect OIB to inlet-> put “in transit”->
press bellows-> open filler –no air should escape.
(3) release filler-set at 10% -rpt above
(4) attach bellows to outlet->block inlet –> set at 2 %
-suck air –> should hear a hissing if safety release
valve is working
EMO(ctd)
• Care-Mark I--empty Al water jacket every 3 months, Mark II &
III- yearly water check
EVALUATION
1. Calibration of EMO is accurate only for intermittent gas
flows; maintains output at 5-13L/min flows. Highest conc.
delivered 16%. If use as plenum i.e. blow air into it –increase
output
2. Climate; Cool-add antifreeze (2% glycol)
Warm- cool by allowing agent to vaporise
-refrigerate
-air will deposit water in cooler vc
3. Splashing during transit if in ON position.
4. Sticking of rotor-PTFE coating in Mk4 (Stetson)
5. Advantage- compact, low cost, portable, useful in mass
casualties, no effect of altitude, easy maintenance, no need
for sterilisation
OXFORD INFLATING BELLOWS
• Self inflating bellows used with
spontaneous/controlled ventillation
• Bellows sit vertically,internal volume
maintained by a spring; 6 bellows- 150 ml
each
• 2 unidirectional flap valves
• Magnet to inactivate distal unidirectional
valve.
Oxford inflating bellows
Spontaneous ventilation
Assisted ventilation
Assisted ventilation
Oxford miniature vaporizer(OMV)
Introduced by Epstein, Macintosh and
Mendelssohn in 1941.
• Conc. Calibrated
• Draw over vaporizer (low resistance)
• Flow over with wicks
• Temperature regulated by means of calcium
chloride( supplied heat)
• Outside the circuit, can be used as plenum
vaporizer
OXFORD MINIATURE VAPORISER(OMV)
• Simple portable inhaler
• for less volatile agents – halo, trilene, chloroform
• Fairly accurate over a short period of time
• 13.5 cm high,1060 gms with full water jacket.
• Control lever, alternative scales for halo(0-4%),tri(0-1.5%),
methoxy (0-0.6%)
• water jacket at base with 25% glycol
• Body stainless steel/wicks of stainless steel gauze
• Plugged into outlet of EMO-performance unaffected by IPPV- can
place on pt side of bellows
• Highest conc delivered 3.5% hal
OMV (ctd)
• Special filler with 2 springs
light pressure-air relief
more pressure-opens filler
• Funnel around filler has capacity of 10ml, covers 1/8th of level
indicator. A second 10ml can be added
• cleaning-drain by tipping after pressing filler lever, wash out
with alcohol or Ether.
• If used with EMO flow is R to L
• Another version for use with continuous flow machine
then flow is L to R
• direction of gas flow marked with an arrow
Disadvantage of OMV-only 20 ml ; cannot mount on backbar
Goldman Vaporizer
• Classification
- concentration calibrated
- flow over without wick
- no temp compensation
- multiple agents –
halothane,trilene
- in or out of system
Goldman vaporizer
• Small glass bowl
• Capacity 20 ml
• Bowl attached to a head, which divide gas b/w
bypass and vaporizing chamber
• Control lever at top; max conc. Delivered at 3rd
mark of 2.21%
• Young modification- added a wick(increase to
4%)
• Halls modification – 2 in series
GOLDMAN VAPORIZER
MARK I MARK II MARK III
1. Self locks Click stops No locking
in off position in each setting
2. DIVISIONS Off-1-2-3-ON Off-1-2- ON
Off -1-2-3-ON
3. Max conc Max conc Max conc
delivered at delivered at delivered at
3 position. 3 position. On.
ROWBOTHAM VAPORISER
• Has a wire gauze
wick
• 2marks to fill till
• Top mark and blue
mark
• Max. at full on
3.10%
ADVANTAGES
• Portable
• Easy to operate
• Low resistance-used as VIC
• Calibrated at high flows of 30 Lpm so safely
use with O2 flush
• Small, inexpensive
• Safe- cannot deliver high conc.’s
DISADVANTAGES
• No temperature compensation- Level of
halothane kept at full mark
• Tilting - pouring of liquid in respiratory
tract
• Back pressure or pumping effect
• Small capacity vaporising chamber - so
delivers low halothane concentration.
• agitation/splashing -5%
Boyle’s bottle vaporizer
• Classification
• 1.Variable bypass
• 2.Flow over or bubble through
• 3.Not temperature
compensated
• 4. Agent specific
(ether,halothane,trilene)
• 5.Outside the circuit
Boyle’s bottle
Boyle Bottles
• Ether Bottle
• Larger vc-300 ml filled fully
• U tube & hood of Cu
• Has 4 lines between off & on-begins to operate
at 2nd
mk
• Trilene bottle -100ml for ½ inch liquid depth
• Chrome plated U tube& hood; cowl adjusted by
stainless steel plunger
• Delivers 0.5-2 %
Boyle Bottles
• Halothane bottle
• Uses only control tap –no plunger/hood
• Control lever marked 1-10 (8%)
starts at 3 , at 4 about 1%
• Inlet tube plugged at end; hole on side 1
cm above
BOYLES BOTTLE
• FACTORS AFFECTING OUTPUT
1. Temp. of liquid
2. Plunger level
3. Control lever position
4. Level of liquid
5. Eccentricity of hood
6. Agitation of vaporiser as during
pouring of liquid in bottle(>5%x 15 secs)
BOYLES BOTTLE
CARE & CLEANING
• Empty after use/allow to dry
• special grease for free rotation of drum
• Plunger loose- tighten the gland nut
• replace packing in gland nut- cotton, neoprene,
nylon
• bottle may chip off leading to leakage
• bottle washer may get damaged
• pressure build up in unused ether bottle
• static charges on cork-chain
Copper Kettle vaporizer
Described by Lucein Morris in 1952.
Classification-
• Measured flow
• Bubble through
• Temperature compensated by supplied heat
and manual flow alteration.
• Multiple agent ( chloroform, ether,halothane)
• Outside the circuit
• 2 models 160ml/400ml
Copper kettle vaporizer
• Constructed of copper
-High heat capacity
- high thermal conductivity
-High degree of accuracy
Copper kettle vaporizer
• A- Filling funnel
• B- Drain
• C- Inlet
• D- Sintered bronze
porex disc
• E- Outlet
Obstetric inhalers
• Emotril
• Cyprane
• Provide TV 250-1000 ml
• work over RR’s of 12-30/min
• resistance of breathing to be
<1.25 cm H2O at 30 LPM.
TEC VAPORIZERS
• CLASSIFICATION (TEC 1 to 5)
1.Variable bypass
2.Flow over with wick
3.Out of system
4.Temp. Compensated by automatic flow
alteration
5.Conc. Calibrated
6.Agent specific
TEC 2
• Used only for Halothane &
methoxyflurane
• Capacity 150 ml
• Calibrated upto 4% (in increments
of 0.5% )
•Temp. compensation by bimetallic
strip
• Filling tap at side, draining at
bottom
•Level indicator on side
•Conc. Dial in front, attached with a
spindle
TEC 2• Not accurate below
4L/min
• <2L/min flow and <2%
dial setting->delivers less
• >2% dial setting ->
deliver more
• With N2O it gives
greater output at lower
setting and less output
at higher setting
• Prone to pressure
changes:
 pumping effect at low
flows
 pressurizing effect at
high flows .
• Care and cleaning
Drain halothane every 2 week and discard as
THYMOL accumulates sticking of spindle and
bimetallic strip.
HAZARDS-
1. Tipping
2. Agitation  high output
3. Reverse flow:->back pressure changes
4. Sticking of control dial due to thymol
5. Between off and 0.5% some output can occur varying
with FGF.
6. Small leak in off position.
TEC 3
Construction:-
1.Conc. Control dial is on top
2.Calibrated from off to 5% in 0.5% gradations
3.Locking lever to be depressed before dial can
be turned
4.Screw cap filler with drain at bottom
5.Optional pin safety system for filling
6.Sight window for liquid level on left
TEC 3
•Used for Halothane, enflurane, isoflurane
& sevoflurane
•Capacity : 135ml (with dry wicks)
100ml ( with wet wicks)
•A bimetallic strip increases flow through
the bypass chamber when temperature
increases.
•Negligible back pressure changes
•No non return valve
•Less affected by fresh gas flow and
composition of carrier gas
•Control knob less likely to stick
Cont...
Internal structure:
• Completely redesigned
• Has 2 sections- lower vaporizing chamber and upper
duct and valve system
• 2 bypass channels- one direct gas stream over
bimetallic strip
• Bimetallic strip at inlet of 2nd
bypass
• Gas exits VC by way of the control channel and joins
gas coming from the bypass
• Bypass is located concentrically within the vaporizing
chamber.
TEC 3
• Accur. falls off at high
flow rates & dial
settings
• All are accurate with
low dial settings
TEC 3
EVALUATION
• Sudden increase or decrease in carrier gas flow,
intermittent back pressure and upstream O2
flush has negligible effect on vapor output.
• N2O has got little effect on output
• Performance in 0-0.5 % range governed mainly
by conc. dial & less by FGF.
• Upto 90° tipping has no effect
HAZARDS:
• FAULTY LOCKING LEVER.
• TIPPING TO 180 DEGREE INCREASES CONCENTRATION
DELIVERED TO > 12%.
• LEAKS SMALL AMOUNT OF VAPOUR IN OFF POSITION.
• REVERSE FLOW INCREASES OUTPUT.
TEC 4
Used for halothane, enflurane and
isoflurane
Entire new look-> Select-a-Tec manifold
Capacity 135ml (with dry wicks)
100 ml ( with wet wicks)
Graduation from 0-5% ( in 0.25%
increments from 0 -1%, and 0.5%
increments thereafter)
Depress release button on left of control
dial to turn on the vaporizer
Locking lever on rear- Vaporizer can be
turned on only if locked on manifold.
Two filling mechanism
1. screw cap with drain plug
2.keyed filling device
Improvement over tec 3
• Output unaffected by back pressure changes under
clinical conditions
• Unaffected by tipping even upto 180°
Limitations-
1. Excess pressure(>400 mmHg) cause decrease in
output.
2.Not so accurate at low flow rates, low dial settings
and larger pressure fluctuations.
3.Overfilling possible.
4.Use of N2O decreases output.
5. Difficulty in operation one handed.
TEC 4
TEC 5
Used for Halothane, isoflurane , enflurane
& sevoflurane
Capacity 300ml ( with dry wicks)
225ml (with wet wicks)
Graduation 0-5% ( 0.2% increments from
0-1% and 0.5% increments thereafter)
Features-
1.Top control dial
2.Locking lever
3. Release button at rear of dial
4.Sight glass – bottom right
5.Keyed filling device:
-FILLING DRAINING PORT
-LOCKING LEVER TO SECURE FILLER BLOCK
-SMALL LEVER AT BASE ALOWS LIQUID TO BE ADDED
OR DRAINED
Tec 5
Features :
• Internal baffle system
• VC lies within the
bypass, which lies along
side of the vaporizer.
• Bimetallic strip at the
base in bypass.
• Before reaching VC –
helical IPPV assembly--
spiral wick.
TEC 5
• Introduced in 1989 responding to criticism of the Tec 4.
Improved features of TEC 5:-
1. Bypass chamber at the base; an improved bimetallic strip.
2. Improved safety interlock.
3. Agent capacity increased from 125 ml to 300 ml.
4. Helical IPPV assembly to minimize effects of PPV.
5. One handed dial control and more obvious “off” position.
6. Service interval now three years.
7. Improved characteristics with tubular woven cotton wicks
8. Accurate with gas flow 5Lpm, dial settings < 3 %.
9. Greatest accuracy between 15-35 degree celcius
Hazards of TEC 5
• More prone to pumping effect then Tec 4.
• Large liquid loss if filling port is opened.
• Overfilling – bottle adaptor loose, vaporizer
on
• Reverse flow increases output.
• Carrier gas composition affects output.
TEC 6
• Classification –
1.Conc. Calibrated
2.Injection vaporizer
3.Thermocompensated by supplied heat or electrically
heated.
4.Electromechanically controlled dual circuit.
5.Gas-vapour blender.
6.pressurized
7.Single agent – Desflurane
• Used only for desflurane.
• Capacity 390ml
• Graduation 1-18% ( 1% increments from 1-
10 and 2% increments thereafter)
• Maximum permissible flow 20L/min
• Since VC is sealed from atm. special filler
system is required.
• Various LEDs in front pannel:-
Amber : without alarm- warm up
Amber : with alarm- agent level below 50 ml
Green : operational
Red :no output due to:--
1. Low agent level <20ml
2. Power failure
3. Malfunction
4. Tilted vaporizer beyond 20 degree
TEC 6
•Desflurane heated to 39 deg
celcius in a sealed chamber,
adjusted by H.
•VP 1300mmHg in sump.
•Carrier gas flow restricted by O,
so that pressure is ~ to flow.
•Pressure sensed by P , which
readjusts R1 so that desflurane
flow is ~ to FGF.
•Control dial adjusts R2, and thus
the output conc.
• H-heater
• O-fixed orifice
• P-differential pressure
transducer
• R1-adjusted by P
• R2-adjusted by control
dial
EVALUATION:-
• Output almost linear at 3%,5%, 7%.
• Slightly low output at <5l/min
• Ideal temp 18-30 deg celcius
• Tilting resistant
• Pumping effect insignificant
• Carrier gas effect minimal.
TEC 7
•Similar to TEC 5
•Used for isoflurane, enflurane , sevoflurane
•Capacity 300ml (with dry wicks)
225ml (with wet wicks)
•Graduation 0-5% ( 0.2% increments from 0-
1 and 0.5% increments thereafter)
•Available with 3 filling devices– funnel filler,
Quikfil, Easyfil.
•New ergonomics and design.
•Soldered sump assembly eliminating seals
•Improved sight glass design
•Clear agent color identification
Tec 7
Characteristics of
Drager Vaporizers
MOST ACCURATE
CLASSIFICATION-
• Conc. calibrated
• Flow over
• Temperature compensated
• Agent specific
• Out of circuit
Drager vapourizers
Drager Vapor 19.1
Used for Halothane, isoflurane,
enflurane and sevoflurane
Capacity 200ml
Calibrated from 0-5% (o.2%
increments in between 0-1 and
1% thereafter)
DRAGER VAPOUR 2000
Penlon sigma delta vaporizer
• Specifications-
• wt :5 kg approx
• Capacity volume : at MAX mark 250 ml
• Flow range: operating flow range .2 to 15 lt/min
SAFETY FEATURE-
1. Keyed filler
2. low filling port
3. Interlocks
4. Secured vaporizers
Cont..
ALADIN CASSETTE VAPORIZER
Classification-
1.Conc. Calibrated
2.Flow over
3.Automatic thermocompensation
4. Agent specific
Features-
1.Cassettes containing liquid anaesthetic inserted into a port
2.Agent recognized and dispensed into the stream of FGF
3.Tipping resistant and maintenance free
4.Power battery backup and adequate O2 pressure mandatory
5.Fixed output irrespective of fresh gas mixture
6.Extremely light and can be removed with one hand.
Use with datex-Engstrom AS/3 ADU
SIEMENS
Classification
• Conc calibrated
• Injection
• No thermocompensation
• A caliberated throttlevalve is opened
and closed by user and thus regulate
the pressure exerted by FGF on
surface of liquid anaesthetic agent
• This pressure tends to force liquid to
atomize at the injector nozzle
• The liquid droplets vaporize in the
flowing FGF.
Agent specific filling system
• A vaporizer designed for a single agent be
fitted with a permanently attached agent
specific device to prevent accidental filling
with wrong agent.
• Reduce air pollution
TYPES-
1.Keyed filling system
2.Screw capped filling system
3.Pin safety system
TEC 4 (KEY FILLER)
TEC 4 (KEY FILLER)
TEC 4 (FUNNEL FILLER)
TEC 4 (FUNNEL FILLER)
KEY FILLERS
KEY FILLER
KEY FILLER
Easy filling system
Quick fill system
Vaporizer mounting system
If >1 vaporizer can be switched on at a time:-
• The patient exposed to a overdose of
anaesthetic agent
• The downstream vaporizer is contaminated.
TYPES-
1.Select a tec back bar- a switch on the back bar
may be used to direct gas flow through only
one vaporizer at a time.
2.A mechanical locking system
3.A mechanical interconnector
Selectatec system
• Pair of port valves for
each vaporizer
• Vaporizer is mounted
and locked on back bar
• When ON 2 plungers
open the valve ports &
activate extension rods
that prevent other
vaporizer.
Vaporizer Mounting Systems
• Only one vaporizer can be turned on
• Gas enters only the “on” vaporizer
• Leak of trace gas is minimized.
BACK BAR DEVICES
• Ohmeda selectatec –has
pins in manifold linked to
control dial
• If one on –extend to
prevent other
DRAGER LOCK
• For Drager 19.2 has
rotating bar on
manifold with teeth
that fit into a cut out
on the control dial
Order of Vap.
Less potent – upstream
More potent – downstream
If equipotent:
low VP – upstream
High VP – downstream
ALSO , If explosive – downstream
Trilene – downstream
Easy to clean - downstream
ORDER OF VAPORISERS
UP STREAM    DOWN
STREAM
SEVOFLURANE ENFLURANE ISOFLURANE HALOTHANE DESFLURANE
VP-157 175 238 243 669
Hazards of contemporary vaporizers
Incorrect agent/ Misfilling
Tipping
Overfilling
Reversed flow
Simultaneous inhaled agent administration
Leaks
Electronic failure
IDEAL VAPORIZER
• Deliver fixed desired conc.
• Independent of-
temp
flow rate
carrier gas alteration
• No effect of back pressure
• easy to maintain and clean
• Agent specific
Vaporizers 2015 spmc

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Vaporizers 2015 spmc

  • 1. VAPORIZERS Dr. deepak kumar Resident in Anaesthesia deptt S.P.Medical College & A.G.Hospitals, Bikaner
  • 2. What is a Vaporizer? A VAPORIZER IS AN INSTRUMENT DESIGNED TO FACILITATE THE CHANGE OF A LIQUID ANAESTHETIC AGENT INTO A VAPOR AND ADD A CONTROLLED AMOUNT OF THIS VAPOR TO THE FGF.
  • 3. Function of Vaporizers • Produce vaporisation of volatile agent • Mix vapour with fresh gas flow • Control the mixture despite variables ►To deliver safe and accurate concentration of inhalational agents to the patient.
  • 4. Applied Physics • Factors affecting vaporization of a liquid 1.Temperature 2.Volatility 3.Surface area 4.Removal of vapor from the vicinity of the liquid.
  • 5. Applied Physics • Vapor • Gas • Critical temperature • Vapor pressure • Boiling point • Partial pressure • Heat of vaporization • Specific heat • Thermal conductivity • Thermal capacity
  • 6. Vapor • Vapor is the gaseous phase of a substance which is normally a liquid at room temp. and atm. pressure Gas • Gas is a substance which exists only in the gaseous state at room temp. and atm.
  • 7. Critical temperature • It is the temperature, above which no amount of pressure will convert a gas to a liquid. 02=-118.4°C; N2O= 36.5°C; CO2= 31°C. • The pressure required to liquefy a gas at its critical temp. is the CRITICAL PRESSURE .
  • 8. Vapor pressure • When enclosed in a container molecules of a volatile liquid break away to form vapor. • Vapor pressure is the pressure with which they bombard the walls of the container. • Vapor pressure depends only on temp and nature of liquid. • Vapor pressure of an agent determines how much of vapour will be formed from 1 ml of the liquid. • Since diff anaesthetic agents have diff vapour pressure so need separate vaporizers.
  • 9. Boiling point • Boiling point of a liquid is that temp at which the vapor pressure is equal to the atmospheric pressure. • Lower the atmospheric pressure, lower the boiling point.
  • 10. Partial pressure • The part of total pressure due to any one gas in the mixture • Depends on – Nature of liquid and Temp. • Clinical significance- Patient uptake and anaesthetic depth are directly related to partial pressure.
  • 11. • HEAT OF VAPORIZATION- It is the number of calories needed to convert 1gm or 1ml of liquid to vapor. • SPECIFIC HEAT- Quantity of heat required to raise the temp of 1gm or 1ml of substance by 1*c .
  • 12. • THERMAL CONDUCTIVITY- A measure of speed with which heat flow through a substance . • THERMAL CAPACITY- Amount of heat stored in vaporizer body = specific heat x Mass
  • 13. CLINICAL SIGNIFICANCE- • liquid with low specific heat vaporize easier. • Higher the thermal conductivity, better a substance conduct heat • Vaporizers construct of material with high thermal conductivity and specific heat e.g.- copper, bronze to minimise temp changes when in use.
  • 14. Related physics THERMOSTABILISATION Methods :-  Vaporizer constructed of metal with high thermal conductivity.  Heavy metal parts act as heat reservoir.  Wicks to be in contact with the metal part so that heat loss due to vaporization is quickly replaced.  Immerse vaporizer chamber in a large mass of water.
  • 15. Related physics THERMOCOMPENSATION- • Some means to maintain the vaporizer output constant despite any temp changes Methods - 1.Alteration in splitting ratio(automatic compensation) e.g.- bimetallic strip in Tec vaporizers, ether filled bellows in penlon vaporizers, EMO(Epstein Macintosh Oxford)
  • 16. Related physics 2.Computer control-electronic vaporizers. 3.Manually adjust flow- measured flow , drager vapor. 4.Supplied heat- Tec 6(electrically heated).
  • 17. Properties Of Common Anaesthetic Agents Agent Boiling Point at 100 kPa (degree Celsius) Vapor Pressure (at 20 deg C) MAC value (vol% ) in 100% O2 1) Ether 34.5 440 19 2) Halothane 50.2 243 0.75 3) Enflurane 56.5 175 1.68 4) Isoflurane 48.5 238 1.15 5) Desflurane 22.8 669 6.4 6) Sevoflurane 58.6 157 2.0 7) Trilene 87.5 57 0.17
  • 18. Terminology for vaporizers PLENUM- FGF is pushed in to the vaporizer(high resistance). DRAWOVER- Gas is pulled in to the vaporizer by the patients own inspiratory effort(low resistance) e.g.- Goldman,EMO,OMV INHALER- A drawover vaporizer in which the carrier is air.
  • 19. SPLITTING RATIO • The ratio of the bypass gas to the gas going to the vaporizing chamber is called the splitting ratio • It depends on- 1.The resistance of the two pathways, which inturn depends on the variable orifice of the inlet/outlet. 2.Temp of the liquid/carrier gas 3. Flow rate of gases.
  • 20. CLASSIFICATION • Dorsch & Dorsch classification (1979) 1) Regulation of output concentration 2) Method of vaporization 3) Location of the vaporizer 4) Temperature compensation 5) Specific anaesthetic agent
  • 21. CLASSIFICATION • Dorsch & Dorsch classification 1) Regulation of output concentration a) Variable Bypass type b) Measured flow type 2) Method of vaporization 3) Location of the vaporizer 4) Temperature compensation 5) Specific anaesthetic agent
  • 25. MEASURED FLOW VAPORIZER • Uses a measured flow of carrier gas to pick up agent • Consist of- 1.Vaporizer 2.flowmeter assembly 3.Vaporizer circuit control valve
  • 26. Cont... • Operator has to set the flow to the vaporizer and bypass with separate flowmeters • This means that respective flows have to be calculated for a given temp and vapour output.
  • 28. CLASSIFICATION • Dorsch & Dorsch classification 1) Regulation of output concentration 2) Method of vaporization a) Flow over b) Bubble through 3) Location of the vaporizer 4) Temperature compensation 5) Specific anaesthetic agent
  • 29. Flow over • A stream of gas passes over liquid surface • Efficiency depend on- 1. Gas-liquid interface e.g.- baffles, spiral tracks, wicks. 2. Velocity of carrier gas flow 3. Height of gas
  • 30. Bubble through • Bubble the gas through the liquid • efficiency depends on- 1. size of bubbles 2. depth of the liquid 3. velocity of carrier gas E.g.- sintered diffuser -cowl in Boyle’s bottle
  • 32. CLASSIFICATION • Dorsch & Dorsch classification 1) Regulation of output concentration 2) Method of vaporization 3) Location of the vaporizer a) VOC(Vaporizer outside the circuit) b) VIC (vaporizer inside the circuit) 4) Temperature compensation 5) Specific anaesthetic agent
  • 33. In system vaporizer(VIC) • Should have standard male and female 22 mm fittings or standard screw threaded fittings,inlet and outlet ports should have arrows. • Should have low resistence. • Vaporiser concentration and output vary • Easy to wash and clean • Drawover vaporizers eg- goldman,EMO,OMV
  • 34. OUT OF SYSTEM VAPORIZERS(VOC) • Usually on back bar – b/w flowmeter and FGF outlet • Most variable bypass vaporizers and all measured flow vaporizers are VOC type.
  • 35. CLASSIFICATION • Dorsch & Dorsch classification 1) Regulation of output concentration 2) Method of vaporization 3) Location of the vaporizer 4) Temperature compensation a) Non compensated b) Compensated 5) Specific anaesthetic agent
  • 38.
  • 39.
  • 40. TEMP COMPENSATION • To maintain a constant output from the vaporizer,mechanisms to compensate for the fluctuations in temp are to be employed. • Method – 1. automatic- alteration in the splitting ratio(bimetallic strip in tec vaporizer,ether filled bellows in penlon vaporizers,EMO 2.Supplied heat- tec 6(electrically heated) 3.Computer control- electronic vaporizers
  • 46. CLASSIFICATION • Dorsch & Dorsch classification 1) Regulation of output concentration 2) Method of vaporization 3) Location of the vaporizer 4) Temperature compensation 5) Specific anaesthetic agent a) Agent specific b) Multiple agent
  • 47. CLASSIFICATION • Gray & Nunn Classification (1971) 1) Plenum vaporizers 2) Draw over vaporizers 3) Vaporizers for use inside a circle anaesthetic system
  • 48. CLASSIFICATION • Gray & Nunn Classification 1) Plenum vaporizers Fresh gas flow is forced into a chamber Unidirectional gas flow Relatively high resistance to gas flow e.g. Boyle vaporizer, copper kettle, Tec series vaporizers
  • 49. CLASSIFICATION • Gray & Nunn Classification 2) Draw over vaporizers/ Inhalers: Air or anaesthetic gases drawn over or through the vaporizer either by pt’s own respiratory efforts or by a self inflating bag or manual bellows. Very low resistance to gas flow e.g. EMO vaporizer, Oxford miniature inhaler, emotril, tecota vaporizers.
  • 50. CLASSIFICATION • Gray & Nunn Classification 3) Vaporizers for use inside a circle anaesthetic system e.g.- Goldman vaporizer Rawbotham vaporizer
  • 51. NEWER CLASSIFICATION. METHOD OF REGULATING OUTPUT CONCENTRATION (1) Conc. Calibrated (2) Measured flow METHOD OF VAPORISATION (1) Flow over (2) Bubble through (3) Injection TEMP. COMPENSATION (1)Thermocompensation (2) Supplied heat
  • 52. Factors affecting vaporizer performance • Flow rate • Temperature • Barometric pressure • Intermittent back pressure • Gas direction • Liquid levels • Anaesthetic agents • Carrier gas composition (N2O causes transient drop)
  • 53. Factors affecting vaporizer performance • Flow rate At high flows,the vaporizer delivers less anaesthetic concentration than is set on the dial problem is solved by increase the surface area of contact b/w the fresh gas and anesthetic agent Eg- WICKS
  • 54. TEMPRATURE • As anaesthetic molecule escape temp decreases more difficult for the remaining molecules to escape less vaporisation. • Thus at lower temp there is less vaporization. • Problem solving-  Giving heat  Giving flow
  • 55. Giving heat 1.Vaporizer material good conductor(high thermal conductivity) act as a heat reservoir(high specific heat) 2.Supplied heat (tec-6 electrically heated)
  • 56. Giving flow • Giving flow (thermocompensation) by alteration in splitting ratio 1. Mechanically 2. Compuer controlled
  • 57. Factors affecting vaporizer performance • Intermittent back pressure Pumping effect(hill and lowe effect) Pressurizing effect(cole effect)
  • 58. Pumping effect(Hill and lowe effect) • The effect of changing pressure during IPPV increasing the output of the vaporizer is called the “pumping effect” • During positive pressure ventilation, pressure transmitted back results in compression of gas. • Since the vaporizing chamber volume is much larger than the ‘by pass’ channel volume, more fresh gas gets compressed in to it.
  • 59. Cont… • This extra fresh gas that enters the vaporizing chamber collects anesthetic vapour • Some of the rapidly expanding gas (containing vapour) enter the inlet of the vaporizer and cross over into the ‘bypass’ channel. • The addition of the ‘bypass’ vapour to the vaporising chamber raises the final concentration of anesthetic delivered.
  • 66. Modifications to reduce the ‘pumping effect’ • By pass channel made larger • Inlet tube made longer • Exclude wicks from inlet • Increased resistance – a high internal resistance to “resist” changes to flow. • Check valve at outlet of the vaporizer -Fluotec 2 • Check valve upstream to junction with the oxygen flush. • Pressure relief valve.
  • 70. One way valve (open)
  • 71. One way valve (closed)
  • 72. Pressurising effect • k/a ‘cole effect’ – decreased output of anesthetic agent. • An inreased in pressure causes an increased pressure inside the vaporizer.The carrier gas is compressed but the vapour pressure of the volatile anesthetic is unaffected.Net result decreased conentration of anesthetic delivered.
  • 74. Carrier gas composition • Most vaporisers are calibrated using 100% o2 • Composition of carrier gas affects output in many(vaporiser aberrance) • If add N2O- decreased output(25% less with 100% N2O)due to solubility of N2O in agent .As N2O dissolves in liquid anaesthetic.Flow of gases exiting vaporiser decreases. • Once saturated with N2O output gradually increases but is less than before(10% less with 100% N2O.
  • 75. EFFECT OF BAROMETRIC PRESSURE • Vaporizers are calibrated at std. atmospheric pressure(at sea level) • Low boiling point,high SVP anaesthetic volatile agents- more susceptible to influence by barometric pressure. • Vapour pressure of agent is independent of barometric pressure. • Effect of low atm. Pressure- deliver HIGHER concentration if measured in volume% but deliver same partial pressure
  • 76. Cont…. • Clinically effect unchanged • Effect of high atm.pressure- increased density of gas increased resistance through vapourising chamber decreased vapour output both in partial pressure and volume%
  • 78. Early methods • OPEN DROP METHOD:- Inhalational anaesthesia by vaporization of a liquid anaesthetic placed drop by drop on a gauze/ mask covering the mouth and nose. Devices- Schimmelbusch mask other modification- Yankauers, Bellamy gardner
  • 79. CONT.. • SEMI OPEN- a frame added to “keep the ether in” in an enclosed area- permitted some degree of rebreathing. e.g.- Ogston’s inhaler Flagg’s can
  • 80. Early devices- open drop method(schimmelbusch mask, yankaeur mask and bellamy gardner wire mask)
  • 81. Semi open drop method Ogston mask with schimmelbusch frame
  • 83. OPEN ETHER ADMINISTRATION • TECHNIQUE- Volatile anaesthetic dripped on to a gauze: 1. ETHER- 16 layers gauze over mask 2. CHLOROFORM/ETHYL CHLORIDE- 12 layers of gauze/1 layer lint(chloroform dropped over half the area) - gradually increased no. Of drops/min - During inspiration air passed through the gauze and vaporizes the liquid anaesthetic into high concentration.
  • 84. Open drop ether • Bellamy gardner dropper - amber coloured - control on pouring - capacity – 90 ml ether
  • 85. INDUCTION • WITH ETHER • RATE OF DROPS 1ST min = 12 drops = 1 % 2nd min = 25 drops = 3 % 3rd min = 50 drops = 6 % 4th min = 100 drops = 10-12 % • ETHYL CHLORIDE - 3 to 5 ml - 3 to 5 % • Rate of drops 1st min = 30 drops 2nd min = 60 drops 3rd min = 90 drops
  • 86. MAINTENANCE • Conc.for maint. with ether is 6 -8 % • Heat loss = 200-300 cal/min • Temp. above and below mask = 2-3 degrees < room temp. • Temp. at mask = 0 – 1 degrees C • Gas comp.under mask 0% ether = 80% N2 + 20% O2 5% ether = 76% N2 + 18% O2 10% ether = 72% N2 + 16% O2
  • 87. Advantage of open drop • Easy to administer • Low dead space 40-60 ml • Low resistence • Wide margin of safety • Relatively cheap
  • 88. Disadvantage of open drop • Significant rebreathing • Hypoxic mixtures may occur • Poor control of inspired gas concentration • Inability to assist or control ventilation • No conservation of heat or humidity • Difficult airway management especially during head and neck procedure • Pollution of the operating room • Hazardous especially with flammable agents. • Skin burn. • Eye injury
  • 89. In system vaporizers(VIC) • There are two ways that gas flows through a vaporizer - push through -Drawover
  • 90. Drawover anaesthesia • Drawover system : - provide anaesthesia without a supply of compressed gases. -Atmospheric air – main carrier gas -drawn by the patient’s inspiratory efforts - volatile agent (ether or halothane) added to vaporizer - Inhaled by the patient via a non-rebreathing valve.
  • 91. Drawover anaesthesia • The component of a drawover circuit
  • 92. EMO Vaporizer Epstein, Macintosh, Oxford (EMO) introduced in 1952 Classification- • Variable bypass/conc. calibrated • Flow over with wicks • Temperature compensated by supplied heat and altered flow. • Agent specific-used for ether, halothane, chloroform and trilene. • Can be a part of a drawover system or used as a plenum vaporizer • Low resistance(<1.25cm water at 40 Lpm flow)
  • 94. • Wt- 6.5 kg ; ht 24cm ;dia 23cm • TRANSIT position- seals ether chamber • CONTROL lever-upto 20% • INLET/OUTLET – R to L • TAP for filling /draining water chamber at bottom • Outlet(male) inlet(female) • 1250ml water filled in water chamber
  • 95. A- Inlet B- Outlet C- Water compartment D- Ether E- Vaporizing chamber F- Thermo compensating valve G- Off/on valve H- Mixing chamber I- Water drain
  • 96. Ctd • FILLER-depress to fill (control lever at 0-not transit- for air to escape) springs back automatically. • LEVEL INDICATOR- moves only after 150 ml ; add 300ml for full (fill with control at 0 –not at ‘in transit’. • TEMP.INDICATOR-rod with black & red bands and metal top 20-25 degrees-black line with metal top >32 degrees – red band- temp above working range
  • 97. EMO(ctd) • Thermocompensation mechanism at outlet of v.c. – metal bellows with liquid Ether[ether capsule] & connected to plunger – temp. range; 15-29 degree Celsius • Water jacket serves as heat reservoir Checks (1) check level indicator-> put “in transit”-> invert – indicator should fall to full. (2) close outlet- connect OIB to inlet-> put “in transit”-> press bellows-> open filler –no air should escape. (3) release filler-set at 10% -rpt above (4) attach bellows to outlet->block inlet –> set at 2 % -suck air –> should hear a hissing if safety release valve is working
  • 98. EMO(ctd) • Care-Mark I--empty Al water jacket every 3 months, Mark II & III- yearly water check EVALUATION 1. Calibration of EMO is accurate only for intermittent gas flows; maintains output at 5-13L/min flows. Highest conc. delivered 16%. If use as plenum i.e. blow air into it –increase output 2. Climate; Cool-add antifreeze (2% glycol) Warm- cool by allowing agent to vaporise -refrigerate -air will deposit water in cooler vc 3. Splashing during transit if in ON position. 4. Sticking of rotor-PTFE coating in Mk4 (Stetson) 5. Advantage- compact, low cost, portable, useful in mass casualties, no effect of altitude, easy maintenance, no need for sterilisation
  • 99. OXFORD INFLATING BELLOWS • Self inflating bellows used with spontaneous/controlled ventillation • Bellows sit vertically,internal volume maintained by a spring; 6 bellows- 150 ml each • 2 unidirectional flap valves • Magnet to inactivate distal unidirectional valve.
  • 104. Oxford miniature vaporizer(OMV) Introduced by Epstein, Macintosh and Mendelssohn in 1941. • Conc. Calibrated • Draw over vaporizer (low resistance) • Flow over with wicks • Temperature regulated by means of calcium chloride( supplied heat) • Outside the circuit, can be used as plenum vaporizer
  • 105. OXFORD MINIATURE VAPORISER(OMV) • Simple portable inhaler • for less volatile agents – halo, trilene, chloroform • Fairly accurate over a short period of time • 13.5 cm high,1060 gms with full water jacket. • Control lever, alternative scales for halo(0-4%),tri(0-1.5%), methoxy (0-0.6%) • water jacket at base with 25% glycol • Body stainless steel/wicks of stainless steel gauze • Plugged into outlet of EMO-performance unaffected by IPPV- can place on pt side of bellows • Highest conc delivered 3.5% hal
  • 106. OMV (ctd) • Special filler with 2 springs light pressure-air relief more pressure-opens filler • Funnel around filler has capacity of 10ml, covers 1/8th of level indicator. A second 10ml can be added • cleaning-drain by tipping after pressing filler lever, wash out with alcohol or Ether. • If used with EMO flow is R to L • Another version for use with continuous flow machine then flow is L to R • direction of gas flow marked with an arrow Disadvantage of OMV-only 20 ml ; cannot mount on backbar
  • 107. Goldman Vaporizer • Classification - concentration calibrated - flow over without wick - no temp compensation - multiple agents – halothane,trilene - in or out of system
  • 108. Goldman vaporizer • Small glass bowl • Capacity 20 ml • Bowl attached to a head, which divide gas b/w bypass and vaporizing chamber • Control lever at top; max conc. Delivered at 3rd mark of 2.21% • Young modification- added a wick(increase to 4%) • Halls modification – 2 in series
  • 109. GOLDMAN VAPORIZER MARK I MARK II MARK III 1. Self locks Click stops No locking in off position in each setting 2. DIVISIONS Off-1-2-3-ON Off-1-2- ON Off -1-2-3-ON 3. Max conc Max conc Max conc delivered at delivered at delivered at 3 position. 3 position. On.
  • 110. ROWBOTHAM VAPORISER • Has a wire gauze wick • 2marks to fill till • Top mark and blue mark • Max. at full on 3.10%
  • 111. ADVANTAGES • Portable • Easy to operate • Low resistance-used as VIC • Calibrated at high flows of 30 Lpm so safely use with O2 flush • Small, inexpensive • Safe- cannot deliver high conc.’s
  • 112. DISADVANTAGES • No temperature compensation- Level of halothane kept at full mark • Tilting - pouring of liquid in respiratory tract • Back pressure or pumping effect • Small capacity vaporising chamber - so delivers low halothane concentration. • agitation/splashing -5%
  • 113. Boyle’s bottle vaporizer • Classification • 1.Variable bypass • 2.Flow over or bubble through • 3.Not temperature compensated • 4. Agent specific (ether,halothane,trilene) • 5.Outside the circuit
  • 114.
  • 116.
  • 117. Boyle Bottles • Ether Bottle • Larger vc-300 ml filled fully • U tube & hood of Cu • Has 4 lines between off & on-begins to operate at 2nd mk • Trilene bottle -100ml for ½ inch liquid depth • Chrome plated U tube& hood; cowl adjusted by stainless steel plunger • Delivers 0.5-2 %
  • 118. Boyle Bottles • Halothane bottle • Uses only control tap –no plunger/hood • Control lever marked 1-10 (8%) starts at 3 , at 4 about 1% • Inlet tube plugged at end; hole on side 1 cm above
  • 119. BOYLES BOTTLE • FACTORS AFFECTING OUTPUT 1. Temp. of liquid 2. Plunger level 3. Control lever position 4. Level of liquid 5. Eccentricity of hood 6. Agitation of vaporiser as during pouring of liquid in bottle(>5%x 15 secs)
  • 120. BOYLES BOTTLE CARE & CLEANING • Empty after use/allow to dry • special grease for free rotation of drum • Plunger loose- tighten the gland nut • replace packing in gland nut- cotton, neoprene, nylon • bottle may chip off leading to leakage • bottle washer may get damaged • pressure build up in unused ether bottle • static charges on cork-chain
  • 121. Copper Kettle vaporizer Described by Lucein Morris in 1952. Classification- • Measured flow • Bubble through • Temperature compensated by supplied heat and manual flow alteration. • Multiple agent ( chloroform, ether,halothane) • Outside the circuit • 2 models 160ml/400ml
  • 122. Copper kettle vaporizer • Constructed of copper -High heat capacity - high thermal conductivity -High degree of accuracy
  • 124. • A- Filling funnel • B- Drain • C- Inlet • D- Sintered bronze porex disc • E- Outlet
  • 125. Obstetric inhalers • Emotril • Cyprane • Provide TV 250-1000 ml • work over RR’s of 12-30/min • resistance of breathing to be <1.25 cm H2O at 30 LPM.
  • 126. TEC VAPORIZERS • CLASSIFICATION (TEC 1 to 5) 1.Variable bypass 2.Flow over with wick 3.Out of system 4.Temp. Compensated by automatic flow alteration 5.Conc. Calibrated 6.Agent specific
  • 127. TEC 2 • Used only for Halothane & methoxyflurane • Capacity 150 ml • Calibrated upto 4% (in increments of 0.5% ) •Temp. compensation by bimetallic strip • Filling tap at side, draining at bottom •Level indicator on side •Conc. Dial in front, attached with a spindle
  • 128. TEC 2• Not accurate below 4L/min • <2L/min flow and <2% dial setting->delivers less • >2% dial setting -> deliver more • With N2O it gives greater output at lower setting and less output at higher setting • Prone to pressure changes:  pumping effect at low flows  pressurizing effect at high flows .
  • 129. • Care and cleaning Drain halothane every 2 week and discard as THYMOL accumulates sticking of spindle and bimetallic strip. HAZARDS- 1. Tipping 2. Agitation  high output 3. Reverse flow:->back pressure changes 4. Sticking of control dial due to thymol 5. Between off and 0.5% some output can occur varying with FGF. 6. Small leak in off position.
  • 130. TEC 3 Construction:- 1.Conc. Control dial is on top 2.Calibrated from off to 5% in 0.5% gradations 3.Locking lever to be depressed before dial can be turned 4.Screw cap filler with drain at bottom 5.Optional pin safety system for filling 6.Sight window for liquid level on left
  • 131. TEC 3 •Used for Halothane, enflurane, isoflurane & sevoflurane •Capacity : 135ml (with dry wicks) 100ml ( with wet wicks) •A bimetallic strip increases flow through the bypass chamber when temperature increases. •Negligible back pressure changes •No non return valve •Less affected by fresh gas flow and composition of carrier gas •Control knob less likely to stick
  • 132. Cont... Internal structure: • Completely redesigned • Has 2 sections- lower vaporizing chamber and upper duct and valve system • 2 bypass channels- one direct gas stream over bimetallic strip • Bimetallic strip at inlet of 2nd bypass • Gas exits VC by way of the control channel and joins gas coming from the bypass • Bypass is located concentrically within the vaporizing chamber.
  • 133.
  • 134. TEC 3 • Accur. falls off at high flow rates & dial settings • All are accurate with low dial settings
  • 135. TEC 3 EVALUATION • Sudden increase or decrease in carrier gas flow, intermittent back pressure and upstream O2 flush has negligible effect on vapor output. • N2O has got little effect on output • Performance in 0-0.5 % range governed mainly by conc. dial & less by FGF. • Upto 90° tipping has no effect HAZARDS: • FAULTY LOCKING LEVER. • TIPPING TO 180 DEGREE INCREASES CONCENTRATION DELIVERED TO > 12%. • LEAKS SMALL AMOUNT OF VAPOUR IN OFF POSITION. • REVERSE FLOW INCREASES OUTPUT.
  • 136. TEC 4 Used for halothane, enflurane and isoflurane Entire new look-> Select-a-Tec manifold Capacity 135ml (with dry wicks) 100 ml ( with wet wicks) Graduation from 0-5% ( in 0.25% increments from 0 -1%, and 0.5% increments thereafter) Depress release button on left of control dial to turn on the vaporizer Locking lever on rear- Vaporizer can be turned on only if locked on manifold. Two filling mechanism 1. screw cap with drain plug 2.keyed filling device
  • 137. Improvement over tec 3 • Output unaffected by back pressure changes under clinical conditions • Unaffected by tipping even upto 180° Limitations- 1. Excess pressure(>400 mmHg) cause decrease in output. 2.Not so accurate at low flow rates, low dial settings and larger pressure fluctuations. 3.Overfilling possible. 4.Use of N2O decreases output. 5. Difficulty in operation one handed.
  • 138. TEC 4
  • 139. TEC 5 Used for Halothane, isoflurane , enflurane & sevoflurane Capacity 300ml ( with dry wicks) 225ml (with wet wicks) Graduation 0-5% ( 0.2% increments from 0-1% and 0.5% increments thereafter) Features- 1.Top control dial 2.Locking lever 3. Release button at rear of dial 4.Sight glass – bottom right 5.Keyed filling device: -FILLING DRAINING PORT -LOCKING LEVER TO SECURE FILLER BLOCK -SMALL LEVER AT BASE ALOWS LIQUID TO BE ADDED OR DRAINED
  • 140. Tec 5 Features : • Internal baffle system • VC lies within the bypass, which lies along side of the vaporizer. • Bimetallic strip at the base in bypass. • Before reaching VC – helical IPPV assembly-- spiral wick.
  • 141. TEC 5 • Introduced in 1989 responding to criticism of the Tec 4. Improved features of TEC 5:- 1. Bypass chamber at the base; an improved bimetallic strip. 2. Improved safety interlock. 3. Agent capacity increased from 125 ml to 300 ml. 4. Helical IPPV assembly to minimize effects of PPV. 5. One handed dial control and more obvious “off” position. 6. Service interval now three years. 7. Improved characteristics with tubular woven cotton wicks 8. Accurate with gas flow 5Lpm, dial settings < 3 %. 9. Greatest accuracy between 15-35 degree celcius
  • 142. Hazards of TEC 5 • More prone to pumping effect then Tec 4. • Large liquid loss if filling port is opened. • Overfilling – bottle adaptor loose, vaporizer on • Reverse flow increases output. • Carrier gas composition affects output.
  • 143. TEC 6 • Classification – 1.Conc. Calibrated 2.Injection vaporizer 3.Thermocompensated by supplied heat or electrically heated. 4.Electromechanically controlled dual circuit. 5.Gas-vapour blender. 6.pressurized 7.Single agent – Desflurane
  • 144. • Used only for desflurane. • Capacity 390ml • Graduation 1-18% ( 1% increments from 1- 10 and 2% increments thereafter) • Maximum permissible flow 20L/min • Since VC is sealed from atm. special filler system is required. • Various LEDs in front pannel:- Amber : without alarm- warm up Amber : with alarm- agent level below 50 ml Green : operational Red :no output due to:-- 1. Low agent level <20ml 2. Power failure 3. Malfunction 4. Tilted vaporizer beyond 20 degree
  • 145. TEC 6 •Desflurane heated to 39 deg celcius in a sealed chamber, adjusted by H. •VP 1300mmHg in sump. •Carrier gas flow restricted by O, so that pressure is ~ to flow. •Pressure sensed by P , which readjusts R1 so that desflurane flow is ~ to FGF. •Control dial adjusts R2, and thus the output conc. • H-heater • O-fixed orifice • P-differential pressure transducer • R1-adjusted by P • R2-adjusted by control dial
  • 146. EVALUATION:- • Output almost linear at 3%,5%, 7%. • Slightly low output at <5l/min • Ideal temp 18-30 deg celcius • Tilting resistant • Pumping effect insignificant • Carrier gas effect minimal.
  • 147. TEC 7 •Similar to TEC 5 •Used for isoflurane, enflurane , sevoflurane •Capacity 300ml (with dry wicks) 225ml (with wet wicks) •Graduation 0-5% ( 0.2% increments from 0- 1 and 0.5% increments thereafter) •Available with 3 filling devices– funnel filler, Quikfil, Easyfil. •New ergonomics and design. •Soldered sump assembly eliminating seals •Improved sight glass design •Clear agent color identification
  • 148. Tec 7
  • 149. Characteristics of Drager Vaporizers MOST ACCURATE CLASSIFICATION- • Conc. calibrated • Flow over • Temperature compensated • Agent specific • Out of circuit
  • 151. Drager Vapor 19.1 Used for Halothane, isoflurane, enflurane and sevoflurane Capacity 200ml Calibrated from 0-5% (o.2% increments in between 0-1 and 1% thereafter)
  • 153. Penlon sigma delta vaporizer • Specifications- • wt :5 kg approx • Capacity volume : at MAX mark 250 ml • Flow range: operating flow range .2 to 15 lt/min SAFETY FEATURE- 1. Keyed filler 2. low filling port 3. Interlocks 4. Secured vaporizers
  • 154. Cont..
  • 155. ALADIN CASSETTE VAPORIZER Classification- 1.Conc. Calibrated 2.Flow over 3.Automatic thermocompensation 4. Agent specific Features- 1.Cassettes containing liquid anaesthetic inserted into a port 2.Agent recognized and dispensed into the stream of FGF 3.Tipping resistant and maintenance free 4.Power battery backup and adequate O2 pressure mandatory 5.Fixed output irrespective of fresh gas mixture 6.Extremely light and can be removed with one hand.
  • 157. SIEMENS Classification • Conc calibrated • Injection • No thermocompensation • A caliberated throttlevalve is opened and closed by user and thus regulate the pressure exerted by FGF on surface of liquid anaesthetic agent • This pressure tends to force liquid to atomize at the injector nozzle • The liquid droplets vaporize in the flowing FGF.
  • 158. Agent specific filling system • A vaporizer designed for a single agent be fitted with a permanently attached agent specific device to prevent accidental filling with wrong agent. • Reduce air pollution TYPES- 1.Keyed filling system 2.Screw capped filling system 3.Pin safety system
  • 159. TEC 4 (KEY FILLER)
  • 160. TEC 4 (KEY FILLER)
  • 161. TEC 4 (FUNNEL FILLER)
  • 162. TEC 4 (FUNNEL FILLER)
  • 163.
  • 164.
  • 165.
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  • 172. Vaporizer mounting system If >1 vaporizer can be switched on at a time:- • The patient exposed to a overdose of anaesthetic agent • The downstream vaporizer is contaminated. TYPES- 1.Select a tec back bar- a switch on the back bar may be used to direct gas flow through only one vaporizer at a time. 2.A mechanical locking system 3.A mechanical interconnector
  • 173. Selectatec system • Pair of port valves for each vaporizer • Vaporizer is mounted and locked on back bar • When ON 2 plungers open the valve ports & activate extension rods that prevent other vaporizer.
  • 174. Vaporizer Mounting Systems • Only one vaporizer can be turned on • Gas enters only the “on” vaporizer • Leak of trace gas is minimized.
  • 175. BACK BAR DEVICES • Ohmeda selectatec –has pins in manifold linked to control dial • If one on –extend to prevent other
  • 176. DRAGER LOCK • For Drager 19.2 has rotating bar on manifold with teeth that fit into a cut out on the control dial
  • 177. Order of Vap. Less potent – upstream More potent – downstream If equipotent: low VP – upstream High VP – downstream ALSO , If explosive – downstream Trilene – downstream Easy to clean - downstream
  • 178. ORDER OF VAPORISERS UP STREAM    DOWN STREAM SEVOFLURANE ENFLURANE ISOFLURANE HALOTHANE DESFLURANE VP-157 175 238 243 669
  • 179. Hazards of contemporary vaporizers Incorrect agent/ Misfilling Tipping Overfilling Reversed flow Simultaneous inhaled agent administration Leaks Electronic failure
  • 180. IDEAL VAPORIZER • Deliver fixed desired conc. • Independent of- temp flow rate carrier gas alteration • No effect of back pressure • easy to maintain and clean • Agent specific